This month, I’m diving into the subject of bariatric design for a trends piece for Healthcare Design magazine’s July issue. While it’s a topic we’ve covered in the past, it’s one that continues to evolve and grow in importance as obesity rates in the United States continue to rise and more patients seek care.

According to the Centers for Disease Control and Prevention, there’s been a dramatic increase in obesity in the U.S. over the last 20 years, with more than one-third of U.S. adults and approximately 17 percent of children and adolescents aged 2-19 years considered obese.

Efforts have been made in recent years to raise awareness of the issue, with much of the focus going to nutrition and exercise, and there’s proof it’s starting to make a difference: From 2003-2010, the prevalence of obesity decreased slightly from 15.21 to 14.94 percent among low-income preschool children, according to a study by the Pediatric Nutrition Surveillance System (PedNSS).

While patients may be better educated on healthy food choices or the need to get 30 minutes of exercise each day, healthcare organizations’ efforts to address bariatric patient needs seem to be slower to evolve. Part of this may stem from a lack of guidelines and knowledge of specific considerations that need to be made, not just related to layout, but also equipment and furnishings.

A question posed on HCD’s LinkedIn Group, The Healthcare Design Connection, asked for a good rule of thumb for specifying bariatric seating in a clinic waiting environment. How much was enough? The post drew lots of discussion and comments, with advice ranging from 10 percent of the furniture in waiting rooms to be bariatric designed up to 20 percent. Others said their rule of thumb was to make it all accessible. Lots of advice but clearly not a consensus on what’s the best practice.

It’s important to address this specific area of design for several reasons. One, with the pending silver tsunami, obesity among older Americans is likely to become a greater problem. There’s also the issue of liability and employee safety. Last but not least, healthcare organizations need to offer safe and dignified care for all patients. That means going beyond thinking about one particular care area to addressing the entire patient experience. Do you have the right equipment in your bathrooms? Can your entrances and doorways accommodate bariatric equipment? Does your space include patients’ family members, since studies show bariatric patients are likely to have overweight family members?  Does your staff know how to treat bariatric patients in a way that makes them feel welcome and cared for?

As the architects, designers, and owners serving the healthcare community, do you think we’re doing enough to address bariatric needs in our facilities? What would you to see happen next? Share your thoughts here or email me at